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Hricak Cancer Imaging 2014, 14(Suppl 1):O1
http://www.cancerimagingjournal.com/content/14/S1/O1
ORAL PRESENTATION
Open Access
Global challenges in oncologic imaging
Hedvig Hricak
From International Cancer Imaging Society (ICIS) 14th Annual Teaching Course
Heidelberg, Germany. 9-11 October 2014
Even as many cancers have been transformed from fatal
to chronic diseases in developed countries, global cancer
incidence and mortality have been rising [1]. While imaging is an essential tool in cancer care, the guidelines
for its use are neither sufficient nor widely recognized.
The needs for imaging equipment and training vary
around the globe but are generally vast. Addressing
these needs will require increased international cooperation. Conferences such as this, donation of equipment,
“teach the teachers” programs, and ongoing education
and consultation with experts via the Internet can all
help. Most importantly, to have a long-lasting impact,
cooperation must be tailored to local needs, engage
local healthcare leaders, and build new generations of
local leaders in oncologic imaging.
With few exceptions (most notably the United Kingdom),
oncologic imaging has yet to mature as a subspecialty
around the world. In the United States, only a handful of
oncologic imaging fellowships exist, and radiologists in
most hospitals are still organized around modalities or
organ systems.
Just as pediatric radiology is not simply general radiology
for small adults, oncologic imaging is not simply the identification of masses added to general body imaging.
Sub-specialized expertise is required for optimal, clinically
relevant interpretation. Oncologic imagers must understand all imaging modalities, even those they do not interpret primarily, to be full partners in multidisciplinary
disease management teams. Yet oncologic imaging is not
recognized as a separate section in board examinations,
and most radiology residents do not perceive it as a potential career path. Formal acknowledgment of the value provided by dedicated oncologic imagers would help raise the
visibility of this critical subspecialty.
Another challenge facing oncologic imaging is the need
to standardize reports to ensure all key points are covered
clearly for each specific kind of cancer [2]. As part of this
Memorial Sloan Kettering Cancer Center, Department of Radiology, New
York, USA
effort, radiologists must learn to utilize quantitative rather
than qualitative terms as much as possible. Not only
should they use numerical scales to express diagnostic certainty, they must also learn to interpret an ever-growing
array of quantitative imaging parameters [3].
Finally, while state-of-the-art equipment is widely available in the United States, the approval and dissemination
of new molecular imaging probes has been frustratingly
slow. To realize the true potential of oncologic imaging
and assure its contribution to precision medicine, we need
to expedite the validation, regulatory approval and dissemination of new tracers–particularly PET tracers, which
have unparalleled molecular specificity. Radionuclide tracers are critical for characterizing tumor heterogeneity in
vivo and are powerful predictive, prognostic and early
response biomarkers. They can be used as companion
diagnostics for targeted therapies and to assess pharmacodynamics/pharmacokinetics. Moreover, they can be integrated into theranostic agents that allow simultaneous
diagnosis, treatment and treatment monitoring [4,5].
All these challenges may seem formidable, but as Alfred
Einstein said, “in the middle of difficulty lies opportunity.”
Despite its lack of recognition, oncologic imaging is poised
to be part of a revolution in cancer care. With dedication,
imagination and cooperation, there is no limit to what we
can accomplish.
Published: 9 October 2014
References
1. Jemal A, Center MM, DeSantis C, Ward EM: Global patterns of cancer
incidence and mortality rates and trends. Cancer Epidemiol Biomarkers
Prev 2010, 19:1893-907.
2. Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H: Improving
communication of diagnostic radiology findings through structured
reporting. Radiology 2011, 260:174-81.
3. Clarke LP, Nordstrom RJ, Zhang H, Tandon P, Zhang Y, Redmond G, et al:
The quantitative imaging network: NCI’s historical perspective and
planned goals. Transl Oncol 2014, 7:1-4.
4. Parkinson DR, McCormack RT, Keating SM, Gutman SI, Hamilton SR,
Mansfield EA, et al: Evidence of Clinical Utility: An Unmet Need in
© 2014 Hricak; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://
creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Hricak Cancer Imaging 2014, 14(Suppl 1):O1
http://www.cancerimagingjournal.com/content/14/S1/O1
5.
Page 2 of 2
Molecular Diagnostics for Patients with Cancer. Clin Cancer Res 2014,
20:1428-1444.
Kircher MF, Hricak H, Larson SM: Molecular imaging for personalized
cancer care. Mol Oncol 2012, 6:182-195.
doi:10.1186/1470-7330-14-S1-O1
Cite this article as: Hricak: Global challenges in oncologic imaging.
Cancer Imaging 2014 14(Suppl 1):O1.
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